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目的 观察非诺贝特干预对高游离脂肪酸(FFA)所致胰岛素抵抗大鼠肌肉组织过氧化物酶体增殖物激活受体γ协同刺激因子1α(PGC-1α)基因表达的影响.方法 将8周龄体重300 g左右雄性SD大鼠分为3组,即正常对照组(10只)、脂肪乳输注组(FFA,10只)及非诺贝特+脂肪乳输注组(F-FFA,10只).3组大鼠在空腹8～10 h后给予颈静脉插管,其中对照组以1 ml/h的速度输注生理盐水6 h,FFA组以1 ml/h的速度输注20%脂肪乳(加入40 U/ml肝素)6 h,F-FFA组为正常大鼠以非诺贝特(100 mg·kg-1·d-1)管喂14 d后继以1 ml/h的速度输注20%脂肪乳(加入40U/ml肝素)6 h,在输注4 h后开始做正常血糖高胰岛素钳夹试验,以葡萄糖输注率(GIR)评价胰岛素敏感性.试验结束后,取骨骼肌肌肉组织,待提取总RNA,行实时定量PCR检测PGC-1α基因的表达.结果 (1)输注脂肪乳6 h后,FFA组血FFA、胰岛素水平较对照组明显增高,F-FFA组血FFA、胰岛素水平较FFA组明显下降[FFA:对照组0.46(0.08～0.72)mmol/L,FFA组1.45(0.87～1.70)mmol/L,F-FFA组0.54(0.06～0.84)mmol/L,均P＜0.01;胰岛素:对照组(6.56±0.78)μIU/ml,FFA组(10.54±0.86)μIU/ml,F-FFA组(6.69±0.84)μIU/ml,均P＜0.01].(2)FFA组GIR较对照组下降约55.6%,存在明显的胰岛素抵抗,非诺贝特干预逆转了约110%[对照组(25.13±2.10)mg·kg-1·min-1,FFA组(10.16±0.75)mg·kg-1·min-1,F-FFA组(21.72±2.89)mg·kg-1·min-1,均P＜0.01].(3)FFA组肌肉组织PGC-1α基因表达较对照组减少约71%,非诺贝特干预后肌肉PGC-1αmRNA表达较FFA组增加约1.50倍(P＜0.01).结论 (1)升高循环中的游离脂肪酸水平可以导致胰岛素抵抗并影响肌肉组织PGC-1α基因的表达.(2)非诺贝特可以改善胰岛素抵抗及PGC-1α基因表达.

Objective To observe the effects of fenofibrate on the expression of peroxisome proliferator-activated (PPAR)-gamma coactivator-1α (PGC-1α) in skeletal muscle of rats with insulin resistance (IR) induced by elevated plasma free fatty acid (FFA) levels. Methods Male Sprague-Dawley (SD) rats were randomly divided into three groups: control group (Con, infused with saline), lipid infusion group (FFA) and fenofibrate treatment plus lipid infusion group (F-FFA). Plasma glucose, insulin and FFA were measured. Glucose infusion rate (GIR) was used to evaluate the insulin sensitivity by euglycemic hyperinsulinemic clamp. The gene expression of PGC-1α in skeletal muscle was determined by real-time polymerase chain reaction (PCR). Results Compared with the control group, the levels of plasma FFA and insulin were elevated significantly in rats infused with lipid, but they decreased significantly in rats pretreated with fenofibrate then infused with lipid [ FFA, Con: 0. 46 ( 0. 08 - 0. 72 ) mmol/L, FFA: 1.45 (0.87-1.70) mmol/L, F-FFA: 0.54 (0.06-0.84) mmol/L, all P<0.01; Insulin, Con: (6.56 ±0.78) μIU/ml, FFA: (10.54±0.86) μIU/ml, F-FFA: (6.69±0.84) μIU/ml, all P<0.01]. In addition, the plasma glucose levels did not change markedly after lipid infusion; GIR was significantly reduced by 55.6% in lipid infusion group, but fenofibrate-pretreatment increased glucose infusion rate (GIR) [Con: (25. 13 ±2. 10) mg · kg-1 · min-1, FFA: ( 10. 16 ±0.75) mg· kg-1 · min-1, F-FFA:(21.72 ±2. 89) mg · kg-1 · min-1, all P <0. 01 ]; the mRNA expression of PGC-1α decreased by about 71% in lipid infusion group but fenofibrate increased the gene expression by about 150% as compared with FFA group ( all P <0. 01 ). Conclusion The elevation of plasma FFA levels may induce IR, and it also decreases the mRNA expression of PGC-1α in skeletal muscle. And fenofibrate pretreatment reverses these changes.